Texas 2021 - 87th Regular

Texas Senate Bill SB1669 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	87R9468 SCL-F
2	2	By: Hall S.B. No. 1669
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to prohibited discrimination regarding vaccination status
8	8	and mandates for receiving or participating in the administration
9	9	of vaccines; authorizing administrative penalties.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	ARTICLE 1. VACCINATION STATUS DISCRIMINATION PROHIBITED
12	12	SECTION 1.01. Subtitle C, Title 5, Business & Commerce
13	13	Code, is amended by adding Chapter 113 to read as follows:
14	14	CHAPTER 113. PROHIBITED DISCRIMINATION BASED ON
15	15	VACCINATION STATUS
16	16	Sec. 113.001. DEFINITION. In this chapter, "public
17	17	accommodation" means a disposition, service, financial aid, or
18	18	benefit provided to members of the public.
19	19	Sec. 113.002. DISCRIMINATION PROHIBITED. A person may not
20	20	discriminate against or refuse to provide a public accommodation to
21	21	an individual based on the individual's vaccination history or
22	22	immunity status for a communicable disease by:
23	23	(1) providing to the individual a public accommodation
24	24	that is different or provided in a different manner than the
25	25	accommodation provided or manner of providing the accommodation to
26	26	other members of the public;
27	27	(2) subjecting the individual to segregation or
28	28	separate treatment in any matter related to providing the public
29	29	accommodation to the individual;
30	30	(3) restricting in any way the individual's enjoyment
31	31	of a public accommodation in a manner that distinguishes the
32	32	individual's enjoyment from the enjoyment of other members of the
33	33	public;
34	34	(4) treating the individual differently from other
35	35	members of the public in determining whether the individual
36	36	satisfies any admission, enrollment, quota, eligibility,
37	37	membership, or other requirement or condition that individuals must
38	38	satisfy before a public accommodation is provided; or
39	39	(5) denying the individual an opportunity to
40	40	participate in a program in a manner that differs from the manner
41	41	the opportunity is provided to other members of the public.
42	42	Sec. 113.003. COMPLAINT; EQUITABLE RELIEF. (a) A person may
43	43	file a complaint with the attorney general if the person asserts
44	44	facts supporting an allegation that another person has violated
45	45	Section 113.002. The person filing the complaint must include a
46	46	sworn affidavit stating that to the person's knowledge, all of the
47	47	facts asserted in the complaint are true and correct.
48	48	(b) If the attorney general determines that a complaint
49	49	filed under Subsection (a) is valid, the attorney general may file a
50	50	petition for a writ of mandamus or apply for other appropriate
51	51	equitable relief in a district court in Travis County or in a county
52	52	in which the person against whom relief is sought resides to compel
53	53	the person to comply with Section 113.002.
54	54	Sec. 113.004. EFFECT ON OTHER LAW. This chapter prevails to
55	55	the extent of a conflict between this chapter and any other law.
56	56	SECTION 1.02. Subchapter A, Chapter 161, Health and Safety
57	57	Code, is amended by adding Sections 161.0057 and 161.0085 to read as
58	58	follows:
59	59	Sec. 161.0057. LONG-TERM CARE FACILITY IMMUNIZATION
60	60	DISCRIMINATION PROHIBITED. (a) In this section, "long-term care
61	61	facility" means a facility licensed or regulated under Chapter 242,
62	62	247, or 252.
63	63	(b) A long-term care facility may not refuse to provide
64	64	services to a resident based on the resident's immunization record
65	65	or immunity status for a communicable disease.
66	66	(c) A long-term care facility that violates this section is
67	67	ineligible to receive state money for services provided to
68	68	residents.
69	69	(d) A violation of this section is a violation of the
70	70	long-term care facility's applicable licensing law and subjects the
71	71	facility to disciplinary action and the imposition of
72	72	administrative penalties under that law.
73	73	(e) This section prevails to the extent of a conflict
74	74	between this section and any other law.
75	75	Sec. 161.0085. IMMUNIZATION RECORD DISCRIMINATION
76	76	PROHIBITED. (a) A health care provider or health care facility may
77	77	not refuse to provide a health care service to a patient because a
78	78	patient is unvaccinated or not immune to a communicable disease.
79	79	(b) A health care facility providing clinical experience to
80	80	satisfy a student's degree requirements may not discriminate
81	81	against a student or prohibit admission, enrollment, or employment
82	82	as a student, intern, or resident because of the student's
83	83	immunization record or immunity status for a communicable disease.
84	84	(c) Notwithstanding any other law, a health care provider or
85	85	health care facility that violates this section is ineligible to
86	86	receive state money for health care services provided to patients.
87	87	(d) A violation of this section is a violation of the health
88	88	care provider's or health care facility's applicable licensing law
89	89	and subjects the facility or provider to disciplinary action and
90	90	the imposition of administrative penalties under that law.
91	91	(e) This section prevails to the extent of a conflict
92	92	between this section and any other law.
93	93	SECTION 1.03. Chapter 544, Insurance Code, is amended by
94	94	adding Subchapter M to read as follows:
95	95	SUBCHAPTER M. VACCINATION STATUS
96	96	Sec. 544.601. DEFINITIONS. In this subchapter:
97	97	(1) "Health benefit plan issuer" means an issuer,
98	98	administrator, or sponsor of a health benefit plan described by
99	99	Section 544.602.
100	100	(2) "Participating provider" means a health care
101	101	provider who has contracted with a health benefit plan issuer to
102	102	provide services to enrollees.
103	103	Sec. 544.602. APPLICABILITY OF SUBCHAPTER. (a) This
104	104	subchapter applies only to a health benefit plan that provides
105	105	benefits for medical or surgical expenses incurred as a result of a
106	106	health condition, accident, or sickness, including a group,
107	107	blanket, or franchise insurance policy or insurance agreement, a
108	108	group hospital service contract, or a group evidence of coverage or
109	109	similar coverage document that is offered by:
110	110	(1) an insurance company;
111	111	(2) a group hospital service corporation operating
112	112	under Chapter 842;
113	113	(3) a health maintenance organization operating under
114	114	Chapter 843;
115	115	(4) an approved nonprofit health corporation that
116	116	holds a certificate of authority under Chapter 844;
117	117	(5) a multiple employer welfare arrangement that holds
118	118	a certificate of authority under Chapter 846;
119	119	(6) a stipulated premium company operating under
120	120	Chapter 884;
121	121	(7) a fraternal benefit society operating under
122	122	Chapter 885;
123	123	(8) a Lloyd's plan operating under Chapter 941; or
124	124	(9) an exchange operating under Chapter 942.
125	125	(b) Notwithstanding any other law, this subchapter applies
126	126	to:
127	127	(1) a small employer health benefit plan subject to
128	128	Chapter 1501, including coverage provided through a health group
129	129	cooperative under Subchapter B of that chapter;
130	130	(2) a standard health benefit plan issued under
131	131	Chapter 1507;
132	132	(3) a basic coverage plan under Chapter 1551;
133	133	(4) a basic plan under Chapter 1575;
134	134	(5) a primary care coverage plan under Chapter 1579;
135	135	(6) a plan providing basic coverage under Chapter
136	136	1601;
137	137	(7) health benefits provided by or through a church
138	138	benefits board under Subchapter I, Chapter 22, Business
139	139	Organizations Code;
140	140	(8) the state Medicaid program, including the Medicaid
141	141	managed care program operated under Chapter 533, Government Code;
142	142	(9) the child health plan program under Chapter 62,
143	143	Health and Safety Code;
144	144	(10) a regional or local health care program operated
145	145	under Section 75.104, Health and Safety Code;
146	146	(11) a self-funded health benefit plan sponsored by a
147	147	professional employer organization under Chapter 91, Labor Code;
148	148	(12) county employee group health benefits provided
149	149	under Chapter 157, Local Government Code; and
150	150	(13) health and accident coverage provided by a risk
151	151	pool created under Chapter 172, Local Government Code.
152	152	(c) This subchapter applies to a life insurance company
153	153	that:
154	154	(1) issues or delivers a life insurance policy in this
155	155	state; or
156	156	(2) is organized under the laws of this state.
157	157	Sec. 544.603. PROHIBITED DISCRIMINATION AGAINST
158	158	INDIVIDUAL. A group health benefit plan issuer or a life insurance
159	159	company may not use an individual's vaccination history or immunity
160	160	status for a communicable disease to:
161	161	(1) reject, deny, limit, cancel, refuse to renew, or
162	162	increase the premiums for coverage of the individual under a plan
163	163	offered by the issuer or company;
164	164	(2) limit the amount, extent, or kind of coverage
165	165	available to the individual; or
166	166	(3) otherwise adversely affect the individual's
167	167	eligibility for coverage.
168	168	Sec. 544.604. PROHIBITED DISCRIMINATION IN GROUP PLAN
169	169	RATING. The vaccination history or immunity status for a
170	170	communicable disease of individuals covered under a group health
171	171	benefit plan that provides coverage in this state may not be used as
172	172	a factor in the rating of the plan.
173	173	Sec. 544.605. PROHIBITED DISCRIMINATION AGAINST
174	174	PARTICIPATING PROVIDER. (a) A health benefit plan issuer may not
175	175	use the vaccination history of a health care provider's patients as
176	176	a qualification or requirement for contracting with the provider or
177	177	as a basis for terminating a contract with the provider.
178	178	(b) A health benefit plan issuer may not use the vaccination
179	179	history or immunity status for a communicable disease of enrollees
180	180	as a factor in providing a financial incentive or assessing a
181	181	financial or other penalty against a participating provider.
182	182	Sec. 544.606. EFFECT ON OTHER LAW. This subchapter
183	183	prevails to the extent of a conflict between this subchapter and any
184	184	other law.
185	185	SECTION 1.04. Chapter 21, Labor Code, is amended by adding
186	186	Subchapter H-1 to read as follows:
187	187	SUBCHAPTER H-1. DISCRIMINATION BASED ON VACCINATION STATUS
188	188	Sec. 21.421. PROHIBITED DISCRIMINATION BASED ON
189	189	VACCINATION STATUS. (a) An employer commits an unlawful employment
190	190	practice if the employer fails or refuses to hire, discharges, or
191	191	otherwise discriminates against an individual with respect to the
192	192	compensation or the terms, conditions, or privileges of employment
193	193	because the individual is unvaccinated or not immune to a
194	194	communicable disease.
195	195	(b) A labor organization commits an unlawful employment
196	196	practice if the labor organization excludes or expels from
197	197	membership or otherwise discriminates against an individual
198	198	because the individual is unvaccinated or not immune to a
199	199	communicable disease.
200	200	(c) An employment agency commits an unlawful employment
201	201	practice if the employment agency classifies or refers for
202	202	employment, fails or refuses to refer for employment, or otherwise
203	203	discriminates against an individual because the individual is
204	204	unvaccinated or not immune to a communicable disease.
205	205	(d) An employer, labor organization, or employment agency
206	206	commits an unlawful employment practice if the employer, labor
207	207	organization, or employment agency limits, segregates, or
208	208	classifies an employee, member, or applicant for employment or
209	209	membership in a way that would deprive or tend to deprive the
210	210	employee, member, or applicant of employment opportunities or
211	211	otherwise adversely affect the status of the employee, member, or
212	212	applicant because the employee, member, or applicant is
213	213	unvaccinated or not immune to a communicable disease.
214	214	Sec. 21.422. EFFECT ON OTHER LAW. This subchapter prevails
215	215	to the extent of a conflict between this subchapter and any other
216	216	law.
217	217	SECTION 1.05. Title 2, Occupations Code, is amended by
218	218	adding Chapter 60 to read as follows:
219	219	CHAPTER 60. IMMUNIZATION DISCRIMINATION
220	220	Sec. 60.001. PROHIBITED DISCRIMINATION BASED ON
221	221	IMMUNIZATION. A licensing authority may not deny an application
222	222	for an occupational license, suspend, revoke, or refuse to renew an
223	223	occupational license, or take any other disciplinary action against
224	224	an individual based on:
225	225	(1) the individual's vaccination history or immunity
226	226	status for a communicable disease; or
227	227	(2) the individual's refusal to be vaccinated or
228	228	participate in administering a vaccine.
229	229	Sec. 60.002. EFFECT ON OTHER LAW. This chapter prevails to
230	230	the extent of a conflict between this chapter and any other law.
231	231	SECTION 1.06. Subtitle A, Title 3, Occupations Code, is
232	232	amended by adding Chapter 103A to read as follows:
233	233	CHAPTER 103A. RIGHT TO OBJECT TO VACCINATIONS
234	234	Sec. 103A.001. RIGHT TO OBJECT. A hospital or other health
235	235	care facility may not require as a condition of employment that an
236	236	employee, including a physician, nurse, or staff member:
237	237	(1) be vaccinated; or
238	238	(2) participate in administering a vaccine.
239	239	Sec. 103A.002. DISCRIMINATION PROHIBITED. (a) A hospital
240	240	or other health care facility may not discriminate against an
241	241	employee, including a physician, nurse, or staff member, or an
242	242	applicant who:
243	243	(1) refuses to:
244	244	(A) be vaccinated; or
245	245	(B) participate in administering a vaccine; or
246	246	(2) is not immune to a communicable disease.
247	247	(b) An educational institution may not discriminate against
248	248	an applicant for admission or employment as a student, intern, or
249	249	resident based on:
250	250	(1) the applicant's vaccination history or immunity
251	251	status for a communicable disease; or
252	252	(2) the applicant's refusal to be vaccinated or
253	253	participate in administering a vaccine.
254	254	Sec. 103A.003. REMEDIES. A person aggrieved by a violation
255	255	of this chapter may bring an action against a hospital, other health
256	256	care facility, or educational institution that administers a
257	257	hospital or other health care facility in a district court in the
258	258	county where the hospital, facility, or institution is located for:
259	259	(1) an injunction against any further violation;
260	260	(2) appropriate equitable relief, including:
261	261	(A) admission or reinstatement of employment;
262	262	and
263	263	(B) back pay and 10 percent interest on the back
264	264	pay; and
265	265	(3) any other relief necessary to ensure compliance
266	266	with this chapter.
267	267	Sec. 103A.004. EFFECT ON OTHER LAW. This chapter prevails
268	268	to the extent of a conflict between this chapter and any other law.
269	269	SECTION 1.07. Subchapter A, Chapter 521, Transportation
270	270	Code, is amended by adding Section 521.013 to read as follows:
271	271	Sec. 521.013. PROHIBITED VACCINATION DISCRIMINATION. (a)
272	272	The department may not use an individual's vaccination history or
273	273	proof of immunity to a communicable disease as a requirement for the
274	274	issuance or renewal of a driver's license, election identification
275	275	certificate, or personal identification certificate.
276	276	(b) The department may not discriminate against, deny
277	277	services or access to, or otherwise penalize any individual for
278	278	being unvaccinated or not providing proof of vaccination or
279	279	immunity to a communicable disease.
280	280	(c) This section prevails to the extent of a conflict
281	281	between this section and any other law.
282	282	ARTICLE 2. VACCINATION MANDATES PROHIBITED
283	283	SECTION 2.01. Section 25.002(a), Education Code, is amended
284	284	to read as follows:
285	285	(a) If a parent or other person with legal control of a child
286	286	under a court order enrolls the child in a public school, the parent
287	287	or other person or the school district in which the child most
288	288	recently attended school shall furnish to the school district:
289	289	(1) the child's birth certificate or another document
290	290	suitable as proof of the child's identity; and
291	291	(2) a copy of the child's records from the school the
292	292	child most recently attended if the child has been previously
293	293	enrolled in a school in this state or another state[; and
294	294	[(3) a record showing that the child has the
295	295	immunizations as required under Section 38.001, in the case of a
296	296	child required under that section to be immunized, proof as
297	297	required by that section showing that the child is not required to
298	298	be immunized, or proof that the child is entitled to provisional
299	299	admission under that section and under rules adopted under that
300	300	section].
301	301	SECTION 2.02. The heading to Section 38.001, Education
302	302	Code, is amended to read as follows:
303	303	Sec. 38.001. RECOMMENDED IMMUNIZATIONS [IMMUNIZATION;
304	304	REQUIREMENTS; EXCEPTIONS].
305	305	SECTION 2.03. Section 38.001(b-1), Education Code, is
306	306	amended to read as follows:
307	307	(b-1) Each year, the Department of State Health Services
308	308	shall prepare a list of the immunizations [required under this
309	309	section for admission to public schools and of any additional
310	310	immunizations] the department recommends for school-age children.
311	311	The department shall prepare the list in English and Spanish and
312	312	make the list available in a manner that permits a school district
313	313	to easily post the list on the district's Internet website as
314	314	required by Section 38.019. A school district or a school,
315	315	including a private school, may not require any immunizations as a
316	316	condition of admission to or attendance at an elementary or
317	317	secondary school.
318	318	SECTION 2.04. Sections 38.019(a) and (b), Education Code,
319	319	are amended to read as follows:
320	320	(a) A school district that maintains an Internet website
321	321	shall post prominently on the website[:
322	322	[(1)] a list, in English and Spanish, of:
323	323	(1) [(A) the immunizations required for admission to
324	324	public school by rules of the Department of State Health Services
325	325	adopted under Section 38.001;
326	326	[(B)] any immunizations or vaccines recommended
327	327	for public school students by the Department of State Health
328	328	Services; and
329	329	(2) [(C)] health clinics in the district that offer
330	330	the influenza vaccine, to the extent those clinics are known to the
331	331	district[; and
332	332	[(2) a link to the Department of State Health Services
333	333	Internet website where a person may obtain information relating to
334	334	the procedures for claiming an exemption from the immunization
335	335	requirements of Section 38.001].
336	336	(b) The list of recommended immunizations or vaccines under
337	337	Subsection (a)(1) [(a)(2)] must include the influenza vaccine[,
338	338	unless the Department of State Health Services requires the
339	339	influenza vaccine for admission to public school].
340	340	SECTION 2.05. The heading to Section 51.933, Education
341	341	Code, is amended to read as follows:
342	342	Sec. 51.933. IMMUNIZATION INFORMATION [REQUIREMENTS;
343	343	EXCEPTION].
344	344	SECTION 2.06. Section 51.933(a), Education Code, is amended
345	345	to read as follows:
346	346	(a) An institution of higher education may not require
347	347	students or applicants for admission to be immunized against any
348	348	communicable disease [diphtheria, rubeola, rubella, mumps,
349	349	tetanus, and poliomyelitis, except as provided in Subsection (d)].
350	350	SECTION 2.07. Section 264.1076(d), Family Code, is amended
351	351	to read as follows:
352	352	(d) A physician or other health care provider conducting an
353	353	examination under Subsection (b) may not administer a vaccination
354	354	as part of the examination without parental consent[, except that a
355	355	physician or other health care provider may administer a tetanus
356	356	vaccination to a child in a commercially available preparation if
357	357	the physician or other health care provider determines that an
358	358	emergency circumstance requires the administration of the
359	359	vaccination]. The prohibition on the administration of a
360	360	vaccination under this subsection does not apply after the
361	361	department has been named managing conservator of the child after a
362	362	hearing conducted under Subchapter C, Chapter 262.
363	363	SECTION 2.08. Section 531.0335(b), Government Code, is
364	364	amended to read as follows:
365	365	(b) The executive commissioner by rule shall prohibit a
366	366	health and human services agency from taking a punitive action
367	367	against a person responsible for a child's care, custody, or
368	368	welfare for declining [failure of the person] to immunize the child
369	369	against any communicable disease [ensure that the child receives
370	370	the immunization series prescribed by Section 161.004, Health and
371	371	Safety Code].
372	372	SECTION 2.09. Section 12.033(a), Health and Safety Code, is
373	373	amended to read as follows:
374	374	(a) Except as otherwise provided by this section, the
375	375	executive commissioner by rule shall adopt fees to be collected by
376	376	the department for the distribution and administration of vaccines
377	377	and sera provided under[:
378	378	[(1) Section 38.001, Education Code;
379	379	[(2) Section 42.043, Human Resources Code;
380	380	[(3)] Chapter 826 (Rabies Control Act of 1981)[;
381	381	[(4) Chapter 81 (Communicable Disease Prevention and
382	382	Control Act); and
383	383	[(5) Section 161.005].
384	384	SECTION 2.10. Section 81.082(f), Health and Safety Code, is
385	385	amended to read as follows:
386	386	(f) In this section, "control measures" does not include an
387	387	immunization or vaccine and includes:
388	388	(1) [immunization;
389	389	[(2)] detention;
390	390	(2) [(3)] restriction;
391	391	(3) [(4)] disinfection;
392	392	(4) [(5)] decontamination;
393	393	(5) [(6)] isolation;
394	394	(6) [(7)] quarantine;
395	395	(7) [(8)] disinfestation;
396	396	(8) [(9)] chemoprophylaxis;
397	397	(9) [(10)] preventive therapy;
398	398	(10) [(11)] prevention; and
399	399	(11) [(12)] education.
400	400	SECTION 2.11. Section 81.085(i), Health and Safety Code, is
401	401	amended to read as follows:
402	402	(i) On request of the department during a public health
403	403	disaster, an individual shall disclose the individual's
404	404	immunization information. If the individual does not have updated
405	405	or appropriate immunizations, the department may take appropriate
406	406	action during a quarantine to protect that individual and the
407	407	public from the communicable disease, but the department may not
408	408	administer a vaccine to the individual without the individual's
409	409	consent.
410	410	SECTION 2.12. The heading to Section 161.0051, Health and
411	411	Safety Code, is amended to read as follows:
412	412	Sec. 161.0051. REQUIRED OFFER OF IMMUNIZATIONS FOR NURSING
413	413	HOMES.
414	414	SECTION 2.13. Subchapter A, Chapter 161, Health and Safety
415	415	Code, is amended by adding Section 161.0055 to read as follows:
416	416	Sec. 161.0055. VACCINATION MANDATES AND DISCRIMINATION
417	417	PROHIBITED. (a) A governmental entity or official, including the
418	418	governor, a state agency, a political subdivision, or a political
419	419	subdivision official, may not:
420	420	(1) require an individual to be vaccinated;
421	421	(2) require an individual to participate in the
422	422	administration of a vaccine; or
423	423	(3) discriminate or impose a civil or criminal penalty
424	424	against an individual who refuses vaccination or participation in
425	425	the administration of a vaccine.
426	426	(b) This section applies to all other law, including an
427	427	agency rule, executive order, or emergency order.
428	428	(c) This section prevails to the extent of a conflict
429	429	between this section and any other law.
430	430	SECTION 2.14. Section 161.0074(c), Health and Safety Code,
431	431	is amended to read as follows:
432	432	(c) The report must:
433	433	(1) include the current immunization rates by
434	434	geographic region of the state, where available;
435	435	(2) focus on the geographic regions of the state with
436	436	immunization rates below the state average for preschool children;
437	437	(3) describe the approaches identified to increase
438	438	immunization rates in underserved areas and the estimated cost for
439	439	each;
440	440	(4) identify changes to department procedures needed
441	441	to increase immunization rates;
442	442	(5) identify the services provided under and
443	443	provisions of contracts entered into by the department to increase
444	444	immunization rates in underserved areas;
445	445	(6) identify performance measures used in contracts
446	446	described by Subdivision (5);
447	447	(7) include the number and type of exemptions used in
448	448	the past year;
449	449	(8) include the number of complaints received by the
450	450	department related to the department's failure to comply with
451	451	requests for exclusion of individuals from the registry;
452	452	(9) identify all reported incidents of discrimination
453	453	for requesting exclusion from the registry [or for using an
454	454	exemption for a required immunization];
455	455	(10) include department recommendations about the
456	456	best way to use, and communicate with, local registries in the
457	457	state; and
458	458	(11) include ways to increase provider participation
459	459	in the registry.
460	460	SECTION 2.15. Section 161.0105(c), Health and Safety Code,
461	461	is amended to read as follows:
462	462	(c) The immunity created by this section is in addition to
463	463	any immunity created by Section [Sections 161.001 and] 161.007(i).
464	464	SECTION 2.16. Section 224.002, Health and Safety Code, is
465	465	amended by amending Subsection (b) and adding Subsection (b-1) to
466	466	read as follows:
467	467	(b) The policy must:
468	468	(1) encourage [require] covered individuals to
469	469	receive vaccines for the vaccine preventable diseases specified by
470	470	the facility based on the level of risk the individual presents to
471	471	patients by the individual's routine and direct exposure to
472	472	patients;
473	473	(2) specify the recommended vaccines a covered
474	474	individual is encouraged [required] to receive based on the level
475	475	of risk the individual presents to patients by the individual's
476	476	routine and direct exposure to patients;
477	477	(3) [include procedures for verifying whether a
478	478	covered individual has complied with the policy;
479	479	[(4) include procedures for a covered individual to be
480	480	exempt from the required vaccines for the medical conditions
481	481	identified as contraindications or precautions by the Centers for
482	482	Disease Control and Prevention;
483	483	[(5)] for a covered individual who declines to receive
484	484	[is exempt from] the recommended [required] vaccines, include
485	485	procedures the individual must follow to protect facility patients
486	486	from exposure to disease, such as the use of protective medical
487	487	equipment, such as gloves and masks, based on the level of risk the
488	488	individual presents to patients by the individual's routine and
489	489	direct exposure to patients;
490	490	(4) [(6)] prohibit discrimination or retaliatory
491	491	action against a covered individual who declines to receive [is
492	492	exempt from] the recommended [required] vaccines [for the medical
493	493	conditions identified as contraindications or precautions by the
494	494	Centers for Disease Control and Prevention], except that required
495	495	use of protective medical equipment, such as gloves and masks, may
496	496	not be considered retaliatory action for purposes of this
497	497	subdivision; and
498	498	(5) [(7)] require the health care facility to maintain
499	499	a written or electronic record of each covered individual's
500	500	immunization record [compliance with or exemption from the policy;
501	501	and
502	502	[(8) include disciplinary actions the health care
503	503	facility is authorized to take against a covered individual who
504	504	fails to comply with the policy].
505	505	(b-1) A health care facility shall maintain as confidential
506	506	an immunization record described by Subsection (b)(5) and may not
507	507	disclose the record to any other person unless the disclosure is
508	508	otherwise required by law.
509	509	SECTION 2.17. Section 31.0031(d), Human Resources Code, is
510	510	amended to read as follows:
511	511	(d) The responsibility agreement shall require that:
512	512	(1) the parent of a dependent child cooperate with the
513	513	commission and the Title IV-D agency if necessary to establish the
514	514	paternity of the dependent child and to establish or enforce child
515	515	support;
516	516	(2) if adequate and accessible providers of the
517	517	services are available in the geographic area and subject to the
518	518	availability of funds, each dependent child, as appropriate,
519	519	complete early and periodic screening, diagnosis, and treatment
520	520	checkups on schedule [and receive the immunization series
521	521	prescribed by Section 161.004, Health and Safety Code, unless the
522	522	child is exempt under that section];
523	523	(3) each adult recipient, or teen parent recipient who
524	524	has completed the requirements regarding school attendance in
525	525	Subdivision (6), not voluntarily terminate paid employment of at
526	526	least 30 hours each week without good cause in accordance with rules
527	527	adopted by the executive commissioner;
528	528	(4) each adult recipient for whom a needs assessment
529	529	is conducted participate in an activity to enable that person to
530	530	become self-sufficient by:
531	531	(A) continuing the person's education or
532	532	becoming literate;
533	533	(B) entering a job placement or employment skills
534	534	training program;
535	535	(C) serving as a volunteer in the person's
536	536	community; or
537	537	(D) serving in a community work program or other
538	538	work program approved by the commission;
539	539	(5) each caretaker relative or parent receiving
540	540	assistance not use, sell, or possess marihuana or a controlled
541	541	substance in violation of Chapter 481, Health and Safety Code, or
542	542	abuse alcohol;
543	543	(6) each dependent child younger than 18 years of age
544	544	or teen parent younger than 19 years of age attend school regularly,
545	545	unless the child has a high school diploma or high school
546	546	equivalency certificate or is specifically exempted from school
547	547	attendance under Section 25.086, Education Code;
548	548	(7) each recipient comply with commission rules
549	549	regarding proof of school attendance; and
550	550	(8) each recipient attend appropriate parenting
551	551	skills training classes, as determined by the needs assessment.
552	552	SECTION 2.18. Sections 42.043(b) and (d), Human Resources
553	553	Code, are amended to read as follows:
554	554	(b) The department shall require that each child at an
555	555	appropriate age have a test for tuberculosis [and be immunized
556	556	against diphtheria, tetanus, poliomyelitis, mumps, rubella,
557	557	rubeola, invasive pneumococcal disease, and hepatitis A and against
558	558	any other communicable disease as recommended by the Department of
559	559	State Health Services. The immunization must be effective on the
560	560	date of first entry into the facility. However, a child may be
561	561	provisionally admitted if the required immunizations have begun and
562	562	are completed as rapidly as medically feasible].
563	563	(d) No immunization may be required for admission to a
564	564	facility regulated under this chapter [if a person applying for a
565	565	child's admission submits one of the following affidavits:
566	566	[(1) an affidavit signed by a licensed physician
567	567	stating that the immunization poses a significant risk to the
568	568	health and well-being of the child or a member of the child's family
569	569	or household; or
570	570	[(2) an affidavit signed by the child's parent or
571	571	guardian stating that the applicant declines immunization for
572	572	reasons of conscience, including a religious belief].
573	573	SECTION 2.19. Section 42.04305, Human Resources Code, is
574	574	amended by amending Subsection (c) and adding Subsection (c-1) to
575	575	read as follows:
576	576	(c) The policy must:
577	577	(1) encourage [require] each facility employee to
578	578	receive vaccines for the vaccine-preventable diseases specified by
579	579	the child-care facility based on the level of risk the employee
580	580	presents to children by the employee's routine and direct exposure
581	581	to children;
582	582	(2) specify the recommended vaccines a facility
583	583	employee is encouraged [required] to receive based on the level of
584	584	risk the employee presents to children by the employee's routine
585	585	and direct exposure to children;
586	586	(3) [include procedures for verifying whether a
587	587	facility employee has complied with the policy;
588	588	[(4) include procedures for a facility employee to be
589	589	exempt from the required vaccines for the medical conditions
590	590	identified as contraindications or precautions by the Centers for
591	591	Disease Control and Prevention;
592	592	[(5)] for a facility employee who declines to receive
593	593	[is exempt from] the recommended [required] vaccines, include
594	594	procedures the employee must follow to protect children in the
595	595	facility's care from exposure to disease, such as the use of
596	596	protective medical equipment, including gloves and masks, based on
597	597	the level of risk the employee presents to children by the
598	598	employee's routine and direct exposure to children;
599	599	(4) [(6)] prohibit discrimination or retaliatory
600	600	action against a facility employee who declines to receive [is
601	601	exempt from] the recommended [required] vaccines [for the medical
602	602	conditions identified as contraindications or precautions by the
603	603	Centers for Disease Control and Prevention], except that required
604	604	use of protective medical equipment, including gloves and masks,
605	605	may not be considered retaliatory action for purposes of this
606	606	subdivision; and
607	607	(5) [(7)] require the child-care facility to maintain
608	608	a written or electronic record of each facility employee's
609	609	immunization record [compliance with or exemption from the policy;
610	610	and
611	611	[(8) state the disciplinary actions the child-care
612	612	facility is authorized to take against a facility employee who
613	613	fails to comply with the policy].
614	614	(c-1) A facility shall maintain as confidential an
615	615	immunization record described by Subsection (c)(5) and may not
616	616	disclose the record to any other person unless the disclosure is
617	617	otherwise required by law.
618	618	SECTION 2.20. The following provisions are repealed:
619	619	(1) Sections 38.001(a), (c), (c-1), (d), (e), and
620	620	(f), Education Code;
621	621	(2) Section 38.001(b), Education Code, as amended by
622	622	Chapters 43 (H.B. 1098) and 94 (H.B. 1059), Acts of the 80th
623	623	Legislature, Regular Session, 2007;
624	624	(3) Section 38.019(a-1), Education Code;
625	625	(4) Section 51.9192, Education Code;
626	626	(5) Sections 51.933(b), (b-1), (d), (d-1), and (e),
627	627	Education Code;
628	628	(6) Section 531.0335(c), Government Code;
629	629	(7) Section 81.023, Health and Safety Code;
630	630	(8) Section 161.001, Health and Safety Code;
631	631	(9) Section 161.004, Health and Safety Code;
632	632	(10) Section 161.0041, Health and Safety Code;
633	633	(11) Section 161.005, Health and Safety Code;
634	634	(12) Section 161.007(h), Health and Safety Code;
635	635	(13) Section 224.002(c), Health and Safety Code;
636	636	(14) Section 224.003, Health and Safety Code;
637	637	(15) Sections 31.031(d) and (e), Human Resources Code;
638	638	(16) Sections 42.043(c), (d-1), and (f), Human
639	639	Resources Code; and
640	640	(17) Section 42.04305(d), Human Resources Code.
641	641	ARTICLE 3. TRANSITION AND EFFECTIVE DATE
642	642	SECTION 3.01. Each facility subject to Chapter 224, Health
643	643	and Safety Code, as amended by this Act, or Section 42.04305, Human
644	644	Resources Code, as amended by this Act, shall modify the facility's
645	645	vaccine-preventable disease policy to conform with the changes in
646	646	law made by this Act not later than January 1, 2022.
647	647	SECTION 3.02. (a) Subchapter M, Chapter 544, Insurance
648	648	Code, as added by this Act, applies only to a health benefit plan or
649	649	insurance policy delivered, issued for delivery, or renewed on or
650	650	after January 1, 2022.
651	651	(b) Section 544.605, Insurance Code, as added by this Act,
652	652	applies only to a contract entered into on or after the effective
653	653	date of this Act.
654	654	SECTION 3.03. (a) The changes in law made by this Act to
655	655	Title 2, Education Code, apply starting with the 2021-2022 school
656	656	year.
657	657	(b) The changes in law made by this Act to Title 3, Education
658	658	Code, apply starting with the 2021-2022 academic year.
659	659	SECTION 3.04. This Act takes effect immediately if it
660	660	receives a vote of two-thirds of all the members elected to each
661	661	house, as provided by Section 39, Article III, Texas Constitution.
662	662	If this Act does not receive the vote necessary for immediate
663	663	effect, this Act takes effect September 1, 2021.